Cardiovascular Diseases Clinical Trial
Official title:
The Effect of Sodium Thiosulfate Treatment on Vascular Calcification in End Stage Renal Failure Patients
Cardiovascular disease is the major cause of death in the hemodialysis population and
calcification of the major arteries (coronary, aorta, and carotid) are a play a central role
in this process. The major causes of the calcification are many, including high levels of
phosphorus, low levels of inhibitors of calcification, positive calcium balance, and
oxidative stress. Once vascular calcification is present, it is usually progressive. There
is no known treatment to reverse established vascular calcification.
Sodium thiosulfate has been used extensively and safely to treat calcific uremic
arteriopathy (a disease, in part due to calcification of small arteries) in dialysis
patients. It increases the solubility of calcium by up to 100,000 fold and is also a potent
anti-oxidant. It therefore has to potential to also decrease the amount of calcium in large
arteries in dialysis patients and, hence improve survival.
We will study hemodialysis (HD) patients at high risk for cardiovascular disease and death
by obtaining a multidetector computerized tomography (MDCT) Scan of the coronary arteries,
carotid arteries and aorta and an assessment of coronary artery stenoses by a simultaneous
intravenous infusion of contrast. At the same setting, we will perform tests of pulse wave
velocity (PWV) and carotid ultrasound carotid intima-media thickness(CIMT)studies. In those
patients at high risk for cardiovascular death, defined as a coronary artery calcification
score (CACS)of greater than 50, sodium thiosulfate at a dose of 12.5-25 gm/1.73 M2 will be
infused over 15-30 minutes after each dialysis treatment for 5 months. The above studies
will then be repeated.
Status | Completed |
Enrollment | 48 |
Est. completion date | November 2009 |
Est. primary completion date | November 2009 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Hemodialysis patient with thrice weekly treatments - Coronary artery calcium score greater than 50 - Age greater than 18 - Compliant with hemodialysis treatments - Informed consent Exclusion Criteria: - Allergy to sodium thiosulfate - Pregnancy - Incarceration - Enrollment in another study - Life expectancy less than 5 months - Expectation of recovery of renal function - Urine output of greater than 200 ml/day or contrast allergy will not receive intravenous contrast |
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Washington University | Saint Louis | Missouri |
Lead Sponsor | Collaborator |
---|---|
Washington University School of Medicine | Barnes-Jewish Hospital, Genzyme, a Sanofi Company |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in Annualized Coronary Calcium Volume Score After Treatment With Sodium Thiosulfate. | We will compare the annualized coronary calcium volume score obtained at the baseline CT of the coronary arteries with another CT obtained of the same coronary arteries following 5 months of sodium thiosulfate treatment. | 5 months | No |
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